Podcast Listener Question Application

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Welcome & Permission* This field is required.Thank you for submitting your relationship question to the Reimagining Love show. The challenge/struggle/pain point that you are bringing forward belongs uniquely to you, but, by being willing to share your story, you are giving all of our listeners a chance to grow, heal, and learn. Your question may be chosen as the inspiration for a conversation between Dr. Solomon and an esteemed guest expert. A conversation that we hope will feel helpful to you and to everyone who listens. We appreciate your willingness to share yourself in this way! Please know that we cannot use all written/audio questions that are submitted, but we are grateful for each and every one. By submitting a question via this form, you are giving permission for your words or voice to be played on the podcast in the case that you are selected for an episode. Do you agree?

YESNO

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Full Name* This field is required.

First Name

Last Name

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E-mail* This field is required.

example@example.com

4

Where do you live?

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Name usage on the episode (please choose one):* This field is required.

You can use my first name when answering my question on the show (ex: "Tayshia has a question about...")

I prefer that my name not be used on the show

6

What are your pronouns? (for example: she/her, they/them, he/him, etc.)* This field is required.

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Agreement* This field is required.Please note that writing in to Reimagining Love is meant to be for educational purposes only. It does not replace or provide medical or psychological advice. If your question is read/played, the discussion is for informational purposes only. You must agree with this if you’d like your question featured on an episode.

I AGREEI DISAGREE

8

File UploadWe'd love to hear your voice! Please submit your question as an audio clip below. (AROUND 1 MINUTE). If you have an iPhone or iPad, you can use the Voice Memos app to record yourself, or use a computer recorder to create an audio file. By uploading a recording, you give permission for your voice to be played on the episode.

Drag and drop files here

Select files to upload

Max. file size: 10.0MB

9

Your QuestionAlternatively please write your question for Dr. Solomon (Audio: AROUND 1 MINUTE | Written: 200 WORDS OR LESS). Please provide some context before you ask your question. For example: who is involved, what has been happening, for how long, what have you already tried in order to make the situation better, and how you feel about the situation . We want to hear about the unique intricacies of your dilemma!  Make sure to omit all names from your question.

0/200

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Would you like to be notified if your question is selected?* This field is required.

YES PLEASE!NOT NECESSARY

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How did you hear about the Reimagining Love podcast?

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Anything else you'd like to share?

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NewsletterWould you like to be added to Dr. Solomon's newsletter for relationships tools, resources, updates about the podcast, and more?

Yes, subscribe me to this newsletter.

No , thank you.

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NewsletterAdd your email here if you would like to be added to Dr. Solomon's newsletter. Each week, you'll receive relationship tools, resources, updates about the podcast, and more.

example@example.com